Left ventricular reconstruction for dilated ischemic cardiomyopathy: biology, registry, randomization, and credibility

G Buckberg - European Journal of Cardio-Thoracic Surgery, 2006 - academic.oup.com
G Buckberg
European Journal of Cardio-Thoracic Surgery, 2006academic.oup.com
Left ventricular reconstruction or restoration shall become the emerging field of treating
dilated cardiomyopathy from either ischemic causes, as in this report from the Cleveland
Clinic, or subsequently from valvular and nonischemic cardiomyopathy [1], because surgical
rebuilding geometrically changes the diseased spherical chamber into a more natural
elliptical form. Registry data confirms collaborative information from the RESTORE
multicenter cohort [2], and Dor [3] who launched this surgical evolution. Furthermore, these …
Left ventricular reconstruction or restoration shall become the emerging field of treating dilated cardiomyopathy from either ischemic causes, as in this report from the Cleveland Clinic, or subsequently from valvular and nonischemic cardiomyopathy [1], because surgical rebuilding geometrically changes the diseased spherical chamber into a more natural elliptical form. Registry data confirms collaborative information from the RESTORE multicenter cohort [2], and Dor [3] who launched this surgical evolution. Furthermore, these functional and mortality late findings are unachievable by CABG with or without mitral valve procedures [4—6].
Randomized testing is underway in the STICH trial, and the Cleveland Clinic re-establishes its vital importance by mirroring their 1978 report regarding the VA Hospital CABG trial [7]. The prior question investigated if a closed artery should be opened, whereas this article tests a comparable biologic principle by surveying mechanical changing of a diseased sphere into conical form with restoration. The original answer was to open the vessel, but revascularization results became distorted by inexperience at the VA centers (2—13% mortality with higher death rate in centers with uncommon cases)[8] compared with 1% CCF mortality in> 1000 patients. Now, the 1% hospital mortality during LV
Oxford University Press
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